James Foster, Deputy Dental Director and Dental Australia/Asia Lead at Dental Protection, details how he and the dedicated dentolegal team supports members every day. 

The way we work has changed since the pandemic, and with a shift to home working, we faced many technological challenges. However, Dental Protection, like many other businesses, has transitioned smoothly to remote working and we have been able to continue to provide support and assistance for members across the world. Since October 2021, we have adopted a ‘hybrid’ approach-- a location-flexible arrangement, allowing us to combine onsite and offsite work dependent on the activity taking place.

For our members in Hong Kong, working in both private and public settings, the impact of COVID-19 has been huge, and the priority for us is to ensure we are up to date and alert to the fast-evolving shape and face of dentistry, and very much aware of the additional stress and pressures that members face.

The team approach

The dentolegal consultants (DLCs) here at Dental Protection work as part of a larger team supporting our members. For dentolegal matters, we work alongside Case Managers and our in-house legal teams. In addition, we may instruct local panel lawyers to assist members in-country, usually when representation is required for such matters as Dental Council investigations or clinical negligence claims.

We also work closely with our Business Development teams in Hong Kong, developing and publishing educational material, presenting events and webinars.

Typically, the five main roles the DLCs carry out to help members are:

1. Responding to dentolegal enquiries

We receive a wide range of requests for assistance that come to us through several different routes. Some come via the Dental Association, some through local panel lawyers, and some come direct from members by email and telephone. Email and telephone requests are the most direct and efficient way to contact us as they allow us to respond as quickly as possible. 

Members can speak directly to me or my colleagues over the phone, where they can raise any current or potential dentolegal issues and request advice on how to deal with them. The nature of the calls received can vary significantly, but some common dentolegal questions are: 

'A patient has requested access to their dental records – am I allowed to share them?'

'The parents of a child patient are divorced and have different wishes regarding treatment – who has the decision-making responsibility in this scenario?'

'I have concerns about a colleague’s behaviour – how and where should I raise these?'

'I am seeing a patient later who has previously complained about an aspect of their care – how should I deal with this?'

'I have received a complaint – how should I respond and what can I do to prevent it from escalating into a legal case?'

'I have received documents from a solicitor indicating that they are bringing a claim of clinical negligence against me. What do I need to do next?'

I always recommend that members call our advice line to discuss something that may be on their mind. It can be reassuring to speak to someone who understands the challenges you are facing and talking to the dentolegal team can help  provide clarity on the issue. Also, the added benefit is that we may be able to help prevent the problem from escalating. 

Sometimes the query can be resolved immediately, but for most matters beyond simple advice we may ask for further details and documentation to be sent in, such as patients’ records and associated correspondence. This then puts us in the best position to understand the details, identify any potential vulnerability, and  assist a member to the best of our ability and with their best interests in mind. 

2. Case handling

3. Supporting members through claims and investigations

We commonly assist members through a whole variety of matters such as providing simple advice, writing reports, assisting with complaint handling and reimbursements for remedial treatment when appropriate. Unfortunately, some colleagues will face the more significant professional challenges of claims in clinical negligence or Dental Council investigations. Such processes are extremely stressful for the individual clinician, and we look to assist members with a non-judgmental, supportive, and proactive approach.

Most days, my colleagues and I will have a team discussion about active cases, especially those that are challenging and require strategic planning, whether these are regulatory matters, complaints, or claims. We will discuss outcomes from similar cases and decide how we can best support the member through the process. 

During a case, it may become clear where third parties reviewing the details (such as expert witnesses acting for a Dental Council) will be critical, and in order to present the most appropriate strategy, risk management advice to the member may include recommending remedial action, such as carrying out further study in relation to the vulnerability established – for example, such areas as communication, consent, or particular clinical procedures. Taking such steps will help demonstrate insight and will act as mitigation to any sentence imposed.  

4. Carrying out clinical reviews on cases

I offer clinical input and advice on cases, providing opinion on whether there has been a breach of duty in the care provided and whether this has resulted in harm to the patient. I liaise closely with our in-house lawyers to create a strategy going forward that will protect our members’ interests. Complaints, claims or regulatory investigations can be enormously challenging for the member hence a large element of my case handling work is based upon offering ongoing reassurance and support to members who are professionally challenged.   

5. Risk management support